<p>PROJECT EVALUATION/ STATE OF CONNECTICUT EXPENDITURE REPORT Connecticut State Library TARGETED GRANT FY 2018 PUBLIC RECORDS ADMINISTRATOR Historic Documents Preservation Program 231 Capitol Ave., Hartford, CT 06106 Connecticut Municipalities GP-003 (rev. 1/2017)</p><p>This form may be completed and printed for submission at ctstatelibrary.org/publicrecords/hdpp</p><p>Name of Municipality: </p><p>Name of Municipal CEO: Title: </p><p>Phone with Area Code: </p><p>Email: </p><p>Name of Town Clerk: Title: </p><p>Phone with Area Code: </p><p>Email: Check if Designated Applicant: </p><p>TC Mailing Address: </p><p>MCEO Address if Different: </p><p>Grant Award Number: Grant Cycle: Cycle 2 Grant Contract Period: The contract period begins after July 1, 2017 AND receipt of the fully executed contract. Grant projects must be completed and funds expended by June 30, 2018. </p><p>Grant Funds Local Funds Total Funds Expenditures Expended (A) Expended (B) Expended (A+B)</p><p>1. Consultants/Vendors $ $ $ </p><p>2. Equipment $ $ $ </p><p>3. Supplies $ $ $ </p><p>4. Town Personnel Costs $ $ $ </p><p>5. Other (Please specify on a separate sheet) $ $ $ </p><p>6. TOTAL $ $ $ </p><p>Final Accounting</p><p>1. Grant Funds Received: $ </p><p>2. Grant Funds Expended: $ 3. Grant Funds Remaining Unexpended (if none, $ enter “0”): Narrative Page</p><p>. Answer on an attached page, numbering the answers for questions 1 through 3. . If the grant funded more than one project, address each project separately; for example, number the answers 1a and 1b, 2a and 2b, 3a and 3b. </p><p>1. Briefly describe the project completed with this grant and indicate whether it achieved the goals outlined in the application. 2. Describe the impact of the project on the records, office or municipality. 3. Describe anything you learned from the project or might have done differently.</p><p>Certification This certification must be signed by the applicant. If the Town Clerk was designated by the MCEO, as indicated on the grant application, the Town Clerk must sign. If the Town Clerk was not designated, the MCEO must sign.</p><p>I hereby certify that the information contained in this report is correct to the best of my knowledge.</p><p>Signature of Applicant (MCEO or Town Clerk if Designated) Date </p><p>Name and Title of Applicant</p><p>Name and Title of Preparer (only if different from Applicant above) Date </p><p>Phone Number of Preparer</p><p>Grantees are encouraged to submit this report immediately upon completion of their grants; that is, June 30, 2018 or earlier. It should be mailed no later than August 10, 2018 to ensure time for receipt and processing at the State Library by September 1, 2018. By statute, this is a receipt deadline, not a postmark deadline. If the municipality does not expend the full grant funds by June 30, 2018, a check for the unexpended funds must be submitted with the report. The check should be made payable to “Connecticut State Library” and may be rounded to the nearest dollar. Prior to June 30th, please contact the grants staff regarding possible reallocation of funds. Mail the signed form and narrative page to:</p><p>Kathy Makover, Field Archivist Connecticut State Library 231 Capitol Avenue Hartford, CT 06106</p>